2018-11-20T03:49:36Zhttp://ijorl.mums.ac.ir/?_action=export&rf=summon&issue=5522015-03-0110.22038Iranian Journal of Otorhinolaryngology2251-72512251-72512015272Halitosis in Otorhinolaryngology PracticeOzanGokdoganTolgahanCatliFikretIleriIntroduction: Halitosis is a common and devastating condition, which may affect up to 1/3 of the population. It can be classified either as genuine halitosis, pseudohalitosis, or halitophobia. Genuine halitosis is more common and usually related to an organic pathology such as periodontitis. Malodour molecules such as sulfur compounds that arise from bacterial interactions generate the basis of oral malodour. Pathologies of the tongue, poor oral hygiene, deep caries, cryptic tonsillary hypertrophia, and postnasal drainage are also associated with halitosis. Gastro-esophageal pathologies and systemic problems are accepted as extra-oral sources of halitosis. There are various methods for the diagnosis of halitosis including objective and subjective methods. General oral hygiene recommendations and specific interventions for the related etiological factors have to be addressed in order to achieve satisfactory results after the treatment. Clinicians have to be aware of these aspects regarding this unfavorable condition to achieve the best results.HalitosisHalitophobiaOral pathologyPseudohalitosisVolatile sulphur compounds20150301145153http://ijorl.mums.ac.ir/article_3611_1fb9c4f62176df2560c1b82612889891.pdf2015-03-0110.22038Iranian Journal of Otorhinolaryngology2251-72512251-72512015272Psychometric properties of the Persian version of the Tinnitus Handicap Inventory (THI-P)Mir MohammadJalaliRobabehSoleimaniMahnazFallahiMohammadAghajanpourMasoumehElahiIntroduction: Tinnitus can have a significant effect on an individual’s quality of life, and is very difficult quantify. One of the most popular questionnaires used in this area is the Tinnitus Handicap Inventory (THI). The aim of this study was to determine the reliability and validity of a Persian translation of the Tinnitus Handicap Inventory (THI-P). Materials and Methods: This prospective clinical study was performed in the Otolaryngology Department of Guilan University of Medical Sciences, Iran. A total of 102 patients aged 23–80 years with tinnitus completed the (THI-P). The patients were instructed to complete the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI). Audiometry was performed. Eight-five patients were asked to complete the THI-P for a second time 7–10 days after the initial interview. We assessed test–retest reliability and internal reliability of the THI-P. Validity was assessed by analyzing the THI-P of patients according to their age, tinnitus duration and psychological distress (BDI and STAI). A factor analysis was computed to verify if three subscales (functional, emotional, and catastrophic) represented three distinct variables. Results: Test–retest correlation coefficient scores were highly significant. The THI-P and its subscales showed good internal consistency reliability (α = 0.80 to 0.96). High-to-moderate correlations were observed between THI-P and psychological distress and tinnitus symptom ratings. A confirmatory factor analysis failed to validate the three subscales of THI, and high inter-correlations found between the subscales question whether they represent three distinct factors. Conclusion: The results suggest that the THI-P is a reliable and valid tool which can be used in a clinical setting to quantify the impact of tinnitus on the quality of life of Iranian patients.AnxietyDepressionQuestionnairesReproducibility of ResultsTinnitusPsychometrics201503018394http://ijorl.mums.ac.ir/article_4037_f74e77d8b3680243726c06b57cb4793f.pdf2015-03-0110.22038Iranian Journal of Otorhinolaryngology2251-72512251-72512015272Results of Acellular Dermis Matrix Graft Used for Tympanoplasty in Guinea Pig ModelFarhadFarahaniAlirezakarimi YazdiMohammadGhasemiElnazShariatpanahiAbdol-MohammadkajbafzadehSaeidAmanpourIntroduction: To describe the underlay tympanoplasty technique using an acellular dermal graft(AlloDerm) for tympanic membrane (TM) reconstruction in a guinea pig model and to demonstrate the feasibility of the technique using AlloDerm tissue harvested from the prepuce as a source of tissue for future grafting in human TM reconstruction. Materials and Methods: The prepuce was divided during circumcision and the acellular dermis was prepared using a number of standard processes. Two groups of guinea pigs were prepared. In the case group (20 guinea pigs and 40 ears) removal of TM was performed with tympanoplasty using AlloDerm, and in the control group (eight guinea pigs and 16 ears), removal of TM was performed without tympanoplasty. In each group, the TM was completely removed in one ear and partially removed on the other side, and the integrity of the TMs was re-evaluated after 8 weeks. Results: In the case group, the healing rates in the completely and partially removed TMs were 83.3% and 94.4%, respectively. The difference in healing rate (0% and 66.7%, respectively) was statistically significant (PPartial perforationTotal perforationTympanoplasty2015030195100http://ijorl.mums.ac.ir/article_3580_583ac1d7a84147ddbc1eb01095ff41be.pdf2015-03-0110.22038Iranian Journal of Otorhinolaryngology2251-72512251-72512015272Tympanoplasty Outcomes: A Review of 789 CasesShabbirIndorewalaTaiwoOlugbemiga AdedejiAbuzarIndorewalaGauravNemadeIntroduction: Tympanoplasty is indicated to restore hearing disability and prevent recurrent otorrhea. Materials and Methods: This study was a retrospective review of patients who underwent tympanoplasty with or without mastoidectomy over a 1-year period. Results: A total of 789 tympanoplasties were reviewed, with a male-to-female ratio of 1:1.1. In total, 91% and 9% of tympanoplasties were performed without and with mastoidectomy, respectively. Complete graft take was observed in 98.6% of cases. Approximately 25% of patients had an air-bone gap (ABG) gap ≤20dB pre-operatively, increasing to 75.6% post-operatively. ABG closure improved from 0.8% to 46.7%. Mean ABG improved from 26.30 ±8.1dB pre-operatively to 14 ± 10.41dB post- operatively (t=28.7, PEndomeatal tympanoplastyHearing improvementGraft materialsTympanoplasty20150301101108http://ijorl.mums.ac.ir/article_3641_d283fcc1ec595c276fb123555ceb6ebd.pdf2015-03-0110.22038Iranian Journal of Otorhinolaryngology2251-72512251-72512015272Stigma in Mothers of Deaf ChildrenHosseinEbrahimiEissaMohammadiMohammad AliMohammadiAkbarPirzadehHamzehMahmoudiIsmailAnsariIntroduction: A deaf child creates a feeling of stigma in many hearing parents. Stigma in mothers can have a negative impact on a child’s treatment and rehabilitation process. Therefore, this study was conducted to evaluate the extent of stigma in mothers with deaf children. Materials and Methods: This descriptive, cross-sectional study was conducted in 2013 among 90 mothers with deaf children. The data-collection instrument included the stigma scale in the mothers of children with disabilities. The reliability and validity of the instrument were confirmed through content validity and Cronbach’s alpha coefficient (α=86%), respectively. Data were analyzed using SPSS-15 software. Results: Results showed that most mothers suffer from stigma due to having a deaf child. The mean stigma score was 96.48 ±27.72. In total, 24.4% of mothers reported that they had received strange and mocking looks; 72.2% regarded child deafness as a sign of divine retribution; and 33.3% felt ashamed of their child’s deafness. There was an inverse relationship between the mother’s level of education and mean stigma scores (PChildrenhearing lossMotherStigma20150301109118http://ijorl.mums.ac.ir/article_3614_643fc53fa95fd00d4533f06cd481d6da.pdf2015-03-0110.22038Iranian Journal of Otorhinolaryngology2251-72512251-72512015272The Effect of Pimecrolimus Cream 1% Compared with Triamcinolone Acetonide Paste in Treatment of Atrophic-Erosive Oral Lichen PlanusAtessaPakfetratZahraDelavarianFarnazFalakiMahboubehKhorashadizadehMinaSabaIntroduction: Oral lichen planus (OLP) is a common chronic mucocutaneous disease. Patients with atrophic and erosive types of OLP often have symptoms of soreness, and require proper treatment. The main treatment for OLP has been the administration of topical or systemic corticosteroids. The objective of this study was to compare the efficacy of adcortyl cream (triamcinolone acetonide in orabase) with topical pimecrolimus cream for the treatment of erosive OLP. Materials and Methods: Twenty-eight patients with OLP were enrolled in a single blind clinical trial and assigned to either a pimecrolimus 1% cream group or an adcortyl 0.1% cream group. The medication was applied every day for 2 months and patients were assessed every 2 weeks. Results: The mean lesion size and mean pain and burning sensation scores did not differ between the pimecrolimus and adcortyl cream groups. The pimecrolimus cream was well tolerated. No clinical drug-related adverse events were observed. Conclusion: Topical pimecrolimus cream may be recommended as a safe and effective alternative therapy in the treatment of OLP. Pimecrolimus cream is as effective as adcortyl cream in managing the signs and symptoms of OLP.Lichen PlanusOralPimecrolimusTriamcinolone AcetonideTherapy20150301119126http://ijorl.mums.ac.ir/article_3575_306f71abc82aa87bea8ba8159b998998.pdf2015-03-0110.22038Iranian Journal of Otorhinolaryngology2251-72512251-72512015272Tongue-tie Repair: Z-Plasty Vs Simple ReleaseJamshidYousofiFaribaTabrizian NaminiSeyed Mohammad AliRaisolsadatRowanGilliesAzarAshkezariJohnMearaIntroduction: Ankyloglossia is a congenital anomaly in which the lingual frenulum is unusually short and thick, thus decreasing tongue mobility. In the context of the newborn or young infant it is a subject of ongoing controversy within and between medical specialties. The controversy involves not only the definition but also the management of this anomaly. A tight lingual frenulum is considered a minor malformation by some investigators. Usual treatments for ankyloglossia include speech therapy, as well as simple frenulotomy and frenuloplasty. The aim of this study was to compare the latter two methods with respect to postoperative results and complications. Materials and Methods: A total of 50 patients referred for surgical care were randomly assigned into two groups: simple release (frenulotomy ) or Z-plasty (frenuloplasty), and underwent a pre-surgical assessment. After 3 months, patients were followed with a scheduled interview and questionnaire comparing the outcomes of the two methods. The data were analyzed using SPSS version 18. Results: Surgery had a significant effect on all variables measured in our study (PmanagementZ-plastyTongue-tie20150301127134http://ijorl.mums.ac.ir/article_3733_81c001bc9d86b9a89a5bdae3b9e9be6d.pdf2015-03-0110.22038Iranian Journal of Otorhinolaryngology2251-72512251-72512015272Reactive Hyperplastic Lesions of the Oral CavityHamidehKadehShirinSaravaniMohammadTajikIntroduction: Peripheral reactive lesions of soft tissue are common oral lesions that dentists face during routine examinations. Diagnosis and development of a treatment plan is difficult if dentists are not aware of the prevalence and clinical symptoms of these lesions. The frequency of these lesions differs across various populations. The aim of this study was to determine the frequency and distribution of oral reactive lesions over a period of 7 years (2006–2012). Materials and Methods: In this retrospective study, available records from the archives of the Department of Pathology, Dental School and the two main hospitals in southeast of Iran (Zahedan) over a period of 7 years (2006–2012) were reviewed. Information relating to the type of reactive lesion, age, gender and location was extracted and recorded on data forms. Data were analyzed using SPSS statistical software (V.18) using the chi-square and Fisher’s exact test. Results: Of 451 oral lesions, 91 cases (20.2%) were reactive hyperplastic lesions. The most common lesions were pyogenic granuloma and irritation fibroma, respectively. These lesions were more frequent in women (60%) than men (40%). The most common locations of involvement were the gingiva and alveolar mucosa of the mandible, and lesions were more common in the 21–40-year age group. The relationship between age group and reactive lesions was statistically significant (P=0.01). Conclusion: The major findings in this study are broadly similar to the results of previous studies, with differences observed in some cases. However, knowledge of the frequency and distribution of these lesions is beneficial when establishing a diagnosis and treatment plan in clinical practice.Fibromaoral cavityPyogenic GranulomaSoft Tissue20150301137144http://ijorl.mums.ac.ir/article_3579_43ce3956fdc0c01684e255ab0be9d19a.pdf2015-03-0110.22038Iranian Journal of Otorhinolaryngology2251-72512251-72512015272Delayed Esophageal Pseudodiverticulum after Anterior Cervical Spine Fixation: Report of 2 CasesAliSadrizadehEhsanSoltaniMehdiAbiliPariaDehghanianIntroduction: Although perforation of the esophagus, in the anterior cervical spine fixation, is well established, cases with delayed onset, especially cases that present pseudodiverticulum, are not common. In addition, management of the perforation in this situation is debated. Case Report: Delayed esophageal pseudodiverticulum was managed in two patients with a history of anterior spine fixation. Patients were operated on, the loose plate and screws were extracted, the wall of the diverticulum was excised, the perforation on the nasogastric tube was suboptimally repaired, and a closed suction drain was placed there. The NGT was removed on the 7th day and barium swallow demonstrated no leakage at the operation site; therefore, oral feeding was started without any problem. Conclusion: In cases with delayed perforation, fistula, or diverticulum removal of anterior fixation instruments, gentle repair of the esophageal wall without persistence on definitive and optimal perforation closure, wide local drainage, early enteral nutrition via NGT, and antibiotic prescription is suggested.Anterior cervical spine fixationConservative ManagementDelayed postoperative complicationEsophageal perforationEsophageal diverticulumFistula managementPlate fixation20150301155158http://ijorl.mums.ac.ir/article_3577_c8c03bde17955a79794c8515b92f9ce4.pdf2015-03-0110.22038Iranian Journal of Otorhinolaryngology2251-72512251-72512015272Oral Verrucous Carcinoma and Ameloblastoma: A Rare CoincidenceZohrehDalirsaniFarnazFalakiNooshinMohtashamLeilaVazifeh MostaanIntroduction: Oral verrucous carcinoma (OVC) is a rare malignancy of the oral cavity that was first described by Ackerman. This tumor is a well-differentiated low-grade, slow growing cancer that is locally invasive without metastasis. Ameloblastoma is one of the most common odontogenic tumors, which originates from the odontogenic epithelium. Verrucous carcinoma along with central ambloblastoma is a rare phenomenon. Case Report: A case of verrucous carcinoma along with central ambloblastoma in a 49-year-old man, which was referred with a painless exophytic lesion with a verrucous and granular surface, is reported. Panoramic radiography revealed a well-defined radiolucency with sclerotic borders. To the best available knowledge, this phenomenon has not yet been reported. Conclusion: Verrucous carcinoma could occur in the wall of odontogenic cysts and tumors and should be considered during the differential diagnosis of a radiolucency, which is observed in the jaws with rapid growth or which presents some changes from its previous appearance. AmeloblastomaCarcinomaJawNeoplasmsVerrucous20150301159163http://ijorl.mums.ac.ir/article_3751_5ecd7b79fd9287c7d943df11bd80c08f.pdf2015-03-0110.22038Iranian Journal of Otorhinolaryngology2251-72512251-72512015272Huge Tongue Lipoma: A Case ReportMohammad AliDamghaniMohammadSafariIntroduction: Lipomas are among the most common tumors of the human body. However, they are uncommon in the oral cavity and are observed as slow growing, painless, and asymptomatic yellowish submucosal masses. Surgical excision is the treatment of choice and recurrence is not expected. Case Report: The case of a 30-year-old woman with a huge lipoma on the tip of her tongue since 3 years, is presented. She had difficulty with speech and mastication because the tongue tumor was filling the oral cavity. Clinical examination revealed a yellowish lesion, measuring 8 cm in maximum diameter, protruding from the lingual surface. The tumor was surgically excised with restoration of normal tongue function and histopathological examination of the tumor confirmed that it was a lipoma. Conclusion: Tongue lipoma is rarely seen and can be a cause of macroglossia. Surgical excision for lipoma is indicated for symptomatic relief and exclusion of associated malignancy.Benign tumorLipomaTongue20150301165169http://ijorl.mums.ac.ir/article_3746_e23b4186ab2309b1cce3e85c88b5320e.pdf2015-03-0110.22038Iranian Journal of Otorhinolaryngology2251-72512251-72512015272Primary Tuberculosis of the Vallecula and Pyriform Sinus:a case report and review of literatureKamyarIravaniShahindokhtbassiri-JahromiMohammad JavadAshrafIntroduction: Tuberculosis (TB) is a relatively prevalent infectious disease caused by a bacterium called mycobacterium tuberculosis. It primarily involves the lungs, but it can also affect other organs causing a variety of symptoms. Case Report: In this report, a rare case with primary involvement of pyriform sinus and vallecula due to tuberculosis in a 74-year-old woman who complained of odynophagia for 6 months, is reported. There were no clinical or radiological pulmonary findings. Conclusion: The authors point out the epidemiological importance of tuberculosis and the need for more suspicion when dealing with uncommon lesions to make an early diagnosis.ExtrapulmonaryPyriform sinusTuberculosisVallecula20150301171175http://ijorl.mums.ac.ir/article_4038_a98e8d0a0ca41c79f6c352154f5ef17d.pdf